Perhaps foodborne illness numbers are down because we do not have the resources to count them?

Being in DC for several days can turn nearly anyone into a “policy wonk.” This is even more so when you are meeting with Congressmemebers, Senators, Staff and Reporters on the progress of Food Safety Legislation. With the CDC numbers that came out yesterday, revising the numbers of foodborne illnesses, and this report, there is still much work to do to lower the incidence of foodborne illnesses. Passing the Food Safety Bill would be a very good start.

The Robert Woods Johnson Foundation Report – “Ready or Not? 2010” Finds States Achieve Highest Ever Scores for Health Emergency Preparedness, But Progress Threatened by Budget Cuts – is a fascinating read on the status of our public health system, and specifically on our ability to do adequate surveillance on biohazards – like foodborne illnesses. According to the report, while states have made progress, there are still a series of major ongoing gaps in preparedness, including in basic infrastructure and funding, biosurveillance, maintaining an adequate and expertly trained workforce, developing and manufacturing vaccines and medicines, surge capacity for providing care in major emergencies, and helping communities cope with and recover from emergencies. Some key findings include:

• 10 states do not have an electronic syndromic surveillance system that can report and exchange information to rapidly detect disease outbreaks;

• Only four states report not having enough staffing capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak;

• 21 states were not able to rapidly identify disease-causing E. coli O157:H7 and submit the lab results in 90 percent of cases within four days.

Ready or Not? provides a series of recommendations that address the ongoing major gaps in emergency health preparedness, including:

• Gaps in Funding and Infrastructure: The resources required to truly modernize public heath systems must be made available to bring public health into 21st century and improve preparedness;

• A Surveillance Gap: The United States lacks an integrated, national approach to biosurveillance, and there are major variations in how quickly states collect and report data which hamper bioterrorism and disease outbreak response capabilities;

• A Workforce Gap: The United States has 50,000 fewer public health workers than it did 20 years ago—and one-third of current workers are eligible to retire within five years. Policies must be supported that ensure there are a sufficient number of adequately trained public health experts—including epidemiologists, physicians, nurses, and other workers—to respond to all threats to the public’s health.

Interesting. The findings in the above report match the experience that I had in the State of Vermont with their part in the National (peanut) Salmonella Outbreak of 2008/2009. I’d have given them, and the coordination with and among all the Federal Agencies, a “D”. I believe S. 510 addresses some of those issues. Hope it improves :)

The Trust For America’s Health (TFAH) is supported financially by the Robert Wood Johnson Foundation, but the report is TFAH’s, not the RWJF’s. The Directors, reviewers and authors represent the National Association of City and County Health Officials, the Association of State and Territorial Health Officers and the Association of Public Health Laboratories. These are all organizations whose members rely heavily on state and federal funds to operate. The TFAH has been producing this report for 8 years. Every year it has called for more funding. Every year it has caused some State Health Officers to cringe as the measuring tools change every year and they must respond to the media why their state was not at the top of the rankings.
Two things of note as I read this annual report once again.
First point is that the Feds have given the states over one billion dollars per year for public health preparedness since the 9/11 and Anthrax attacks. In 2009, the total was over two billion dollars, a record high. The total is now over 11 billion dollars. This report does help hold the states accountable for the use of these dollars and does point out the improvements made over the last decade.
Second point is that Bill’s home state of Washington is one of only 3 that scored a perfect 10. Reflects highly on his State Health Officer, Mary Selecky.